Orientation and property of fibers of the myodural bridge in humans
Orientation and property of fibers of the myodural bridge in humans
复制标题
人类肌硬膜桥纤维的方向和特性。
DOI：
10.1016/j.spinee.2018.02.006
复制
发表时间：
2018-06-01
期刊：
影响因子：
4.5
通讯作者：
Sui, Hong-Jin
中科院分区：
文献类型：
--
作者：
Zheng, Nan;Chi, Yan-Yan;Sui, Hong-Jin
背景情况：近20年来的研究表明，枕下肌、项韧带和颈硬脊膜之间存在纤维结缔组织。这种与&DM的纤维连接通过后寰枕或寰枢间隙，称为肌硬脊膜桥（MDB）。研究人员推断MDB可能具有重要功能。推测MDB的作用可能与传递本体感觉、保持蛛网膜下腔和小脑延髓池的通畅、影响脑脊液的动态循环有关。此外，临床医生发现MDB的病理改变可能引起颈源性或慢性紧张型头痛。以前的大体解剖学和组织学研究仅证实了MDB的存在，但没有揭示MDB的纤维特性。目的：本研究采用多种组织学染色方法，揭示MDB的不同来源和纤维特性。观察了寰枕或寰枢后间隙参与形成MDB的肌肉和韧带，并证实了MDB的纤维特性。本研究为推测MDB对SDM的张力值提供了依据，为探讨MDB的生理功能和临床意义提供了形态学基础工作。研究设计：对在寰枕或寰枢椎后间隙与SDM相通的枕下结构进行解剖学和组织学分析。采用多种组织学染色方法评价5例福尔马林固定的头颈部人体标本中寰枕或寰枢椎后间隙MDB的组织学特性和组成。结果表明，寰枕间的MDB起源于头后小直肌（RCPmi）。寰枢椎间的MDB主要起源于RCPmi、头后大直肌和头下肌。这些纤维在寰枢椎间隙中形成脊椎硬脊膜韧带并与SDM连接。MDB主要由平行运行的I型胶原纤维形成，因此，在头部运动过程中，枕下肌可以通过MDB传播的有效力来拉动SDM。结论：肌硬脊膜桥主要由平行运行的I型胶原纤维形成，因此，它可以在头部运动过程中传递来自不同枕下肌或韧带的强大拉力。本研究的结果将作为进一步的生物力学和功能MINI研究的基础。(C)2018爱思唯尔公司All rights reserved.
BACKGROUND CONTEXT: Studies over the past 20 years have revealed that there are fibrous connective tissues between the suboccipital muscles, nuchal ligament, and cervical spinal dura mater (SDM). This fibrous connection with the &DM is through the posterior atlanto-occipital or atlantoaxial interspaces and is called the myodural bridge (MDB). Researchers have inferred that the MDB might have important functions. It was speculated that the function of MDB might be related to proprioception transmission, keeping the subarachnoid space and the cerebellomedullary cistern unobstructed, and affecting the dynamic circulation of the cerebrospinal fluid. In addition, clinicians have found that the pathologic change of the MDB might cause cervicogenic or chronic tension-type headache. Previous gross anatomical and histologic studies only confirmed the existence of the MDB but did not reveal the fiber properties of the MDB. This is important to further mechanical and functional research on the MDB.PURPOSE: Multiple histologic staining methods were used in the present study to reveal the various origin and fiber properties of the MDB. Muscles and ligaments participating in forming the MDB at the posterior atlanto-occipital or atlantoaxial interspaces were observed, and the fiber properties of the MDB were confirmed. The present study provides a basis for speculating the tensile force values of the MDB on the SDM and a morphologic foundational work for exploring the physiological functions and clinical significances of the MDB.STUDY DESIGN: Anatomical and histologic analyses of suboccipital structures that communicate with the SDM at the posterior atlanto-occipital or atlantoaxial interspaces were carried out.METHODS: Multiple histologic staining methods were used to evaluate the histologic properties and composition of the MDB at the posterior atlanto-occipital or atlantoaxial interspaces in five formalin-fixed head-neck human specimens.RESULTS: The results show that the MDB traversing the atlanto-occipital interspace originated from the rectus capitis posterior minor (RCPmi). The MDB traversing the atlantoaxial interspace originated mainly from the RCPmi, rectus capitis posterior major, and obliquus capitis inferior. These fibers form the vertebral dural ligament in the atlantoaxial interspace and connect with SDM. The MDB is mainly formed by parallel running type I collagen fibers; thus, suboccipital muscle could pull SDM strongly through the effective force propagated by the MDB during head movement.CONCLUSIONS: Myodural bridge is mainly formed by parallel running type I collagen fibers; thus, it can transmit the strong pull from the diverse suboccipital muscles or ligaments during head movement. The results of the present study will serve as a basis for further biomechanical and functional MINI research. (C) 2018 Elsevier Inc. All rights reserved.